Does the Stomach Regain Size After Sleeve Gastrectomy? A Possible Downside to One Bariatric Surgery Technique

Wed, 07/15/2009 - 18:00 — Angela

• Clinical Study |
• Weight loss surgery

 

As more and more people seek bariatric surgery to aid in major weight loss, a variety of techniques have been developed.  One of the techniques that we don’t hear about in the news as frequently is sleeve gastrectomy, in which the size of the stomach is reduced to a narrow tube (essentially removing a large part of the stomach to produce a smaller stomach cavity and decrease hunger).

Unlike the lap band, which is intentionally reversible, a sleeve gastrectomy is intended to be permanent.  One question about the surgery, though, is whether the stomach can increase in size after the surgery, especially if patients don’t carefully follow the limits on meal size that are required.   Some studies have even suggested that within three years, patients might need to have another surgery in order to prevent weight gain.

Checking for Stomach Stretching

A team of surgeons at the University of Chile, led by Dr. Italo Braghetto, have conducted measurements of stomach capacity with patients who have undergone sleeve gastrectomies, checking their stomach capacity within three days of their surgery and again after two years.

This study, reported in the journal Obesity Surgery in January 2009, followed fifteen patients and found that the average stomach capacity did increase significantly over the two years after their surgeries.  In fact, the average gastric capacity had more than doubled.  These same patients had, for the most part, maintained their weight loss and had average Body Mass Index (BMI) of 25 (although an increase in BMI was seen in a few patients). 

Although the patients had made and maintained significant weight loss, the study suggests that regaining of weight reported by earlier studies over the longer term following a sleeve gastrectomy might be due to the increase in stomach size.

Psychological Barriers

Dr. Braghetto and his team report that patients have a hard time limiting themselves to the very small meals necessary to maintain their new, smaller stomach size.  Some gradually increase the size of their meals, while others keep meals small but make them more frequent.  Because their stomachs empty quickly, they are more likely to feel hungry.

The Bottom Line

If you’re considering sleeve gastrectomy, this study suggests you need to be ready to commit to strictly following the limitations on meal size if you wish to avoid regaining weight or repeating surgery.

This study, reported in the journal Obesity Surgery in January 2009, followed fifteen patients and found that the average stomach capacity did increase significantly over the two years after their surgeries. In fact, the average gastric capacity had more than doubled. These same patients had, for the most part, maintained their weight loss and had average Body Mass Index (BMI) of 25 (although an increase in BMI was seen in a few patients).


Gosh there's been thousands of VSG done in the US they could ONLY get 15 for THIS STUDY to print it in Obesity Surgery journal...? weird...
and also...since my ? to Frisco is mainly about his statement re: bougie sizes...did these 15 post VSG pts. in this article have a "36 or over" bougie size? and WHY did ONLY a "few patients" in this article have an increase in BMI after 2 years? and not any more IF indeed their stomachs DOUBLED in size? makes me wonder!

I hope this article isn't reachin the masses...with the ridiculousness of it...people would be flockin to DS or RNY!!

ETA: also it came from Chile...maybe they DO make their stomachs BIG to begin with
I can't do anything with this study ...at this point.

But thanks for the reply!!

objective was not to get into a bougie size war no point in that, surgeons all make different sizes with varied reasons,and then not to mention technique...In the end we have what we have, and have to live with that.. i posted this study more to let people know that even though a small test preformed this study does show that portion sizes may affect the out come further out...

I think those of us out further realise that even though we might be able to eat a small amount when it comes to dense protein we certainly can eat a ton of crap food...well i know i can

I think the message to newbies should be, eat a measured amount of food and try not rely on our restriction only... because their may be evidence that sleeves do stretch over time.

 
Why would you think a sleeve cannot stretch?

It is tissue.....not bone.....or steel

The bigger sleeves retain more stretchy tissue and the will stretch out more than a smaller sleeve. My surgeon who has been doing the VSG for 10 years started with a 46f bougie, patients lost weight the first year but there regain rates were very high because they were able to eat much more because there 46f retained to much of the stretchy tissue. He actually has a mathematical number for the difference between a 32f and a 46f and it is substantial.

Any one person can make any size sleeve work.....it is ultimately up to you


frisco

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